Dr Dale Bramley
Dr Lester Levy
Quality Achievements for 2013/2014
At the heart of healthcare is the need to respect the intrinsic dignity of each and every person. It is a privilege to work in healthcare to be able to serve our community and to assist in relieving the suffering that many healthcare conditions cause.
Our Promise Statement to our community is ‘Best Care for Everyone’. This is the quality standard for how we work together. As a result of this promise we seek continuous improvement in everything we do. We aim to provide care that is safe, clinically effective, and focused on the individual needs of every patient and their whānau that enters our care. We aim to achieve health outcomes and patient experience that are among the best in the world and to be the leader in New Zealand.
This quality account is a dedicated report about the quality of our services and what we are doing to meet our promise. It describes our achievements for the last year, what we have done well, where improvements can be made, and our plans for next year.
We have achieved some outstanding results. In 2013 we had the lowest rate of hospital deaths among all 20 District Health Boards and the rate of hospital deaths continues to decline each year. We have achieved and exceeded the targets for the national patient safety priorities set by the Health Quality and Safety Commission [view our quality and safety marker results], including consistent gold standard hand hygiene practice, assessing vulnerable older patients’ risk of falling and ensuring patients at high risk of falling have a falls care plan in place, and ensuring staff in our operating theatres consistently use the World Health Organisation’s surgical safety checklist.
We have undertaken a number of quality improvement projects in response to feedback from our patients and their whānau, incidents occurring in our hospitals, and our quality data [view more about projects for Safe Care, Clinically Effective Care, and Patient and Family Centred Care]. A few of these projects are described for you in this quality account. One example is the introduction of an ‘Enhanced Recovery After Surgery’ (ERAS) programme to improve the experience of patients who suffer a hip fracture. This is an example of our clinicians working in partnership with patients, their whānau, the community and our quality improvement team. As a result we have seen significant improvement for our patients – they are getting surgery faster, mobilising within 24-hours of surgery and waiting less time to access rehabilitation [view more about ERAS: recovering faster from a broken hip].
In preparing this quality account we listened to our community and have included a new section ‘What Matters to Our Patients and Families’ with information that our consumers and community requested we include in our quality account. This includes information that will help patients while they are in hospital - for example identifying staff by uniform, how our volunteers can help, and how patients can keep themselves safe from superbugs [view more about what matters to our patients and families ].
In addition to engaging our patients and community, we know there’s a strong link between a highly engaged workforce and high quality patient care and health outcomes. We report on a number of initiatives to enhance or staff experience, such as the enhanced care management and clinical leadership programme that has over 100 clinicians participating in the design of services and care processes that improve health, cost and patient experience outcomes; a weekly forum for our charge nurse managers and senior nurse leaders to focus on quality performance across our hospital wards; and an electronic reporting system enabling our ward staff to track quality indicators in real time and immediately instigate improvements in the care they provide to their patients and whānau [view more about initiatives to increase quality capability and accountability].
In the last 12 months our DHB was privileged to be able to host Robert Francis QC, who is best known in New Zealand for chairing the inquiry into the Mid Staffordshire National Health Service Foundation (Mid Staffordshire NHS Foundation). His advocacy for a common culture of putting patients first, fundamental standards of quality of care, and strong clinical leadership gave us a valuable opportunity to reflect as an organisation on our enduring commitment to these principles.
We know that we have work to do to improve the quality of our services. Following the visit from Robert Francis we have started a patient and whānau centred care standards programme to ensure we get the basics right for our patients and their whānau, such as always having a clean environment, receiving appropriate observations and monitoring, being well-fed, getting enough rest, and having pain well managed [view more about patient and whānau centred care standards] . In the next year we will work with the Health Quality and Safety Commission and the northern region DHBs to improve patient safety including reducing harm from high risk medications; we will collaborate with Counties Manakau DHB and general practice medical centres to improve patient safety in the community; we will access better patient experience information by hosting more listening events with our patients and whānau, and by surveying our patients using a national and local surveys; and we will use our patient experience information to drive continuous improvement [view more about projects currently underway for 2014/15].
We look forward to receiving your feedback on this quality account and your suggestions about how we can improve the quality of services we provide.
Waitemata DHB values and promise statement